| NPI | 1730316639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: VT 055.0030985) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2025-08-20 |